Monday, June 27, 2011

Time to Rethink Your Birth Control?

Time to Rethink Your Birth Control?

The Pill (oral contraceptive) is the most popular birth control choice among American women, but a new practice bulletin from the American College of Obstetricians and Gynecologists (ACOG) indicates that we might be picking wrong. Instead, the organization says that long-acting reversible contraceptives (LARCs) such as IUDs and implants are the most effective options, and that they’re safe for almost all women. I asked Jill Rabin, MD, chief of ambulatory care, obstetrics and gynecology, head of urogynecology at Long Island Jewish Medical Center in New Hyde Park, New York, to explain why more women should consider using IUDs and implants.

What are the main benefits of IUDs and implants compared to other types of birth control?

The main plus is that there’s no regular maintenance required (i.e., you don’t have to remember to take a pill every day), so it’s very unlikely that you’d end up with an unwanted pregnancy while using one. But it’s also worth noting that some IUDs (the kind that releases hormones) help to make periods lighter. “For women who suffer from abnormally heavy and prolonged periods, it really creates a big benefit,” says Dr. Rabin.

Why are IUDs and implants currently underused in this country?

In the past, there wasn’t enough education (of doctors and patients) about them. But as the evidence that these methods are very safe and effective has grown, that’s started to change. “I think IUD usage is going to continue to increase as time goes on and more data is accumulated on the safety and efficiency,” says Dr. Rabin.

Is it true that women who haven’t yet had kids can’t use IUDs?

Not at all. Although some doctors have been reluctant to use them in younger women, in part because of the off-chance that they could get an infection that might interfere with their fertility, that outlook is changing because it’s so unlikely. “IUDs may be used in women who have never borne a child as well as in adolescents,” says Dr. Rabin.

Any other myths about long-acting contraceptives?

“Many women are under the impression that the copper IUD is a ten-year commitment and the hormonal IUD a five-year commitment, but that’s misinformation,” says Dr. Rabin. Instead, those numbers refer to the maximum amount of time you can keep either device in before it needs to be replaced. “A patient can choose to stop using the device or change to a different method at any time.”